Your Breasts: What’s Normal, What’s Not?

Your breasts go through changes when you have your period, when you’re pregnant or breastfeeding, and when you go through puberty and its flip side, menopause. But outside of these times, what’s normal? And when should you check in with your doctor?

Your Breasts

Each breast has 15 to 20 sections, or lobes, that surround the nipple like spokes on a wheel. Inside these lobes are smaller lobes, called lobules. At the end of each lobule are tiny "bulbs" that make milk. These things are linked together by small tubes called ducts, which carry milk to the nipples.

The nipple is in the center of a darker area of skin called the areola. The areola contains small glands called Montgomery glands, which lubricate the nipple during breastfeeding. Fat fills the spaces between the lobes and ducts. There are no muscles in the breasts, but the pectoral or chest muscles lie under each breast and cover the ribs.

Each breast also contains blood vessels, as well as vessels that carry a fluid called lymph. Lymph travels throughout the body through a network called the lymphatic system. The lymphatic system carries cells that help the body fight infections. The lymph vessels lead to the lymph nodes (small bean-shaped glands).

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Breast development and function depend on the hormones estrogen and progesterone, which are made in the ovaries. Estrogen elongates the ducts and makes them create side branches. Progesterone increases the number and size of the lobules in order to prepare the breast for feeding a baby.

After ovulation, progesterone makes the breast cells grow and blood vessels enlarge and fill with blood. At this time, the breasts often become engorged with fluid and may be tender and swollen.

Here’s what to know about breast issues that you may notice.

Nipple Discharge

This includes any fluid that comes out of your nipple. It can happen during pregnancy and breastfeeding. It can even continue up to 2 years past the time you stop nursing. This is all normal.

A milky-white leakage from both breasts can also happen before menopause. This is due to hormones. It’s not uncommon.

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But if the discharge is bloody, greenish, or clear; if it affects only one breast; if there’s a lump; or if it happens without prodding, see your doctor, whether you’re in menopause or not. The cause could be an infection, a sac filled with fluid called a cyst, other lumps that aren’t cancer (such as fibroadenomas), or cancer.

Your doctor will give you a checkup, including a physical exam of both breasts. They’ll ask about your symptoms and family’s medical history. You may also get a mammogram or sonogram to check inside the breast.

Lumps

Try not to worry. But do see your doctor to find out what it is. This is especially important if you notice large lumps in your armpit or if the bumpy area doesn’t go away after 6 weeks.

Most breast lumps -- more than 80% -- aren’t cancer. Most of the time, they show up when you have your period or are nearing menopause. They can be small or large in size and feel hard or squishy. Many are harmless cysts filled with fluid.

Your doctor will check your breasts and will probably recommend a mammogram and possibly other tests. They may use a needle to remove a bit of the fluid from the area or take a small sample of the lump for more testing.

It’s a good idea to get to know what’s normal for your breasts. That way, if you notice something different, you can work with your doctor to find out what it is.

Color and Texture Changes

If the skin around your breasts becomes dimpled, itchy, scaly, or red, you should check in with your doctor. They may just keep an eye on this or order a biopsy -- removing a small piece of tissue -- to make sure everything is OK.

Soreness and Tenderness

It could just be “that” time of the month. A lot of women feel this way before or during their periods. This is normal, and usually the pain goes away on its own. But get it checked out if the pain gets worse, if it’s in one area of your chest, or if it affects your daily routine (like working out or picking up your kids).

Things that can cause breast pain include birth control pills, a large cup size, and hormones. During your exam, your doctor may consider whether it might help to change the type of birth control pills (if you’re on them) or adjust your hormone therapy (if you take it for menopause symptoms). For some types of breast pain, it may help to cut down on caffeine.

Changes in Size or Shape

Your breasts may change during different points in your life. For instance, this can happen when you have your period and when you’re pregnant, often enlarging due to hormones.

Once you reach menopause, you may feel like your chest sags, becoming smaller and losing its shape. This is normal. 

But if you notice changes outside of this time -- if your breasts look or feel different -- check with your doctor to make sure everything is OK.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on June 17, 2020

Sources

SOURCES:

John Hopkins Medicine: “Nipple Discharge,” “Normal Breast Development.”

Mayo Clinic: “Nipple Discharge.”

Susan G Komen: “Benign Breast Conditions”

American Cancer Society: “Mammogram Basics.”

Cleveland Clinic: “I’ve found a breast lump.”

National Cancer Institute: “Understanding Breast Changes: A Health Guide for Women,” "Breast Anatomy."

American Cancer Society: “For Women Facing a Breast Biopsy.”

Mayo Clinic: “Breast Pain.”

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